Clindamicina intravítrea como alternativa terapéutica en la toxoplasmosis ocular severa / Intravitreal clindamycin as a therapeutic alternative in severe ocular toxoplasmosis

La toxoplasmosis ocular es una enfermedad que puede tener graves consecuencias visuales. El objetivo es presentar un caso clínico de toxoplasmosis ocular bilateral severa en una paciente alérgica a sulfamidas en el que la reactivación monolateral de la enfermedad responde de forma favorable ante el tratamiento con clindamicina intravítrea y corticoterapia oral. Se muestra como la administración de clindamicina mediante inyecciones intravítreas semanales supone una alternativa terapéutica segura en aquellos casos de toxoplasmosis ocular severa y/o en los que existe contraindicación para el tratamiento clásico. La clindamicina intravítrea es una alternativa terapéutica segura con resultados clínicos favorables

Ocular toxoplasmosis is a disease than have severe consequences on the eyesight. The aim of this study article is to present a bilateral ocular toxoplasmosis in a sulfamide allergic patient with unilateral activation and her favourable progression with intravitreal Clindamycin and oral steroids treatment. Weekly intravitreal Clindamycin treatment is shown to be a suitable therapeutic alternative in cases of severe ocular toxoplasmosis and/or in patients with a contraindication to classical treatment. Intravitreal Clindamycin treatment is a safe alternative with favourable clinical results

Intravitreal clindamycin as a therapeutic alternative in severe ocular toxoplasmosis. / Clindamicina intravítrea como alternativa terapéutica en la toxoplasmosis ocular severa.

Ocular toxoplasmosis is a disease than have severe consequences on the eyesight. The aim of this study article is to present a bilateral ocular toxoplasmosis in a sulfamide allergic patient with unilateral activation and her favourable progression with intravitreal Clindamycin and oral steroids treatment. Weekly intravitreal Clindamycin treatment is shown to be a suitable therapeutic alternative in cases of severe ocular toxoplasmosis and/or in patients with a contraindication to classical treatment. Intravitreal Clindamycin treatment is a safe alternative with favourable clinical results.

Birdshot- like retinocoroidopatía como comienzo de la enfermedad de Whipple / Birdshot-like retinochoroidopathy as onset of Whipple's disease

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[Determination of normality limit of blood pressure by home self-measurement]. / Determinación del límite de normalidad de la presión arterial mediante la automedida domiciliaria.

OBJECTIVES: Home blood pressure (HBP) is frequently used in clinical evaluation; however the interpretation of the data collected is lacked of a precide definition of normal HBP, so we did this study. METHODS: A random sample of 1,136 was selected, stratified by gender and age (25 up to 64 years old). Those receiving antihypertensive therapy were excluded. Clinical blood pressure (CBP) consisted of three measurements, with the mercury sphygmomanometer (MS) and with the automatic blood pressure device (Omron 705 CP) (AD). Heart rate (HR), body weight and height were registered. HBP: each participant was asked to obtain 9 home measurements, three in the morning (M), three in the afternoon (A) and three at night (N). Statistical methods included Student's t test for paired comparisons, ANOVA and regression analysis. RESULTS: CBP and HBP measurements (mmHg) were obtained in 734 participants. The means of S-CBP/D-CBP with the MS were 123.5 +/- 15.1/ 76.4 +/- 10.4 and 122.4 +/- 14.4/75.6 +/- 10.0 and with the AD, 123.4 +/- 16.1/73.7 +/- 10.4. The average of S-HBP/D-HBP in the total sample was 115.0 +/- 14.3/69.2 +/- 9.0. The HBP measurements were significantly lower than CBP (p < 0.05). The mean of clinic HR was 70.3 +/- 10.4. The average of home HR in the whole sample was 67.9 +/- 9.7. The clinic HR and the home HR were significantly different (p < 0.05). The upper limit of normality for HBP obtained from the values that correspond on the mean +2 SD to the CBP value of 140/90 was 135/82. The 95th percentile value of the HBP in the whole sample was 131/80. The upper limit of normality for HBP obtained from the values that correspond on the regression lines in the group with CBP < 140/90 was 125/78, in the group with CBP >or= 140/90 was 130/81 and in the total sample was 128/81. CONCLUSIONS: We consider that the upper limit of normality of home blood pressure is 130/81. Clinic heart rate is higher than home heart rate, which demonstrates a phenomenon of alerting reaction.

Determinación del límite de normalidad de la presión arterial mediante la automedida domiciliaria / Determination of normality limit of blood pressure by home self-measurement

Objetivos. Dada la gran utilización de este nuevo método diagnóstico que es la AMPA, y la escasa clarificación sobre los valores de normalidad se realizó este estudio. Método. Se seleccionó una muestra de 1.136 personas, de forma aleatoria y estratificada por edad y sexo, de 25 a 64 años. Se excluyeron a los diagnosticados de HTA. En consulta (C) se determinó la PA mediante el esfigmomanómetro de mercurio (Hg) y el aparato automático Omron 705 CP (ap. autom.). Se registró la frecuencia cardíaca (FC), la talla y el peso. En el domicilio (D) se les pidió que obtuviesen 9 mediciones de PA, tres por la mañana (M), tres por la tarde (T) y tres por la noche (N). Se aplicó la «t» de Student de medias pareadas, ANOVA y regresión lineal. Resultados. Las mediciones de PA (mmHg) en C y D se obtuvieron en 734 participantes. Las medias de presión sistólica (PS)/presión diastólica (PD) en C con el esfigmomanómetro Hg fueron 123,5 ± 15,1/76,4 ± 10,4 y 122,4 ± 14,4/75,6 ± 10,0 y con el ap. autom. 123,4 ± 16,1/73,7 ± 10,4. La media de PS/PD en el D de toda la muestra fue 115,0 ± 14,3/69,2 ± 9,0. Al compararla PA de la C y del D existieron diferencias significativas entre las determinaciones en C en relación con las del D (p < 0,05). La media de FC en la C fue 70,3 ± 10,4 (pulsaciones/ minuto). La media de FC en el D de toda la muestra fue 67,9 ± 9,7 siendo superior en C que en el D. Al determinar el límite superior de normalidad en el D mediante la media +2 DE en el grupo seleccionado con una PA en C < 140/90 fue 135/82; mediante el percentil 95 correspondió a 131/80 en el total de la muestra. Al aplicar la regresión a la muestra de participantes con PA < 140/90 se obtuvieron unos valores del límite de normalidad en el D de 125/78; en el grupo de personas seleccionadas con PA ≥ 140/90 fue 130/81 y en la muestra total fue de 128/81

Objectives. Home blood pressure (HBP) is frequently used in clinical evaluation; however the interpretation of the data collected is lacked of a precide definition of normal HBP, so we did this study. Methods. A random sample of 1,136 was selected, stratified by gender and age (25 up to 64 years old). Those receiving antihypertensive therapy were excluded. Clinical blood pressure (CBP) consisted of three measurements, with the mercury sphygmomanometer (MS) and with the automatic blood pressure device (Omron 705 CP) (AD). Heart rate (HR), body weight and height were registered. HBP: each participant was asked to obtain 9 home measurements, three in the morning (M), three in the afternoon (A) and three at night (N). Statistical methods included Student's t test for paired comparisons, ANOVA and regression analysis. Results. CBP and HBP measurements (mmHg) were obtained in 734 participants. The means of S-CBP/D-CBP with the MS were 123.5 ± 15.1/ 76.4 ± 10.4 and 122.4 ± 14.4/75.6 ± 10.0 and with the AD, 123.4 ± 16.1/73.7 ± 10.4. The average of S-HBP/D-HBP in the total sample was 115.0 ± 14.3/69.2 ± 9.0. The HBP measurements were significantly lower than CBP (p < 0.05). The mean of clinic HR was 70.3 ± 10.4. The average of home HR in the whole sample was 67.9 ± 9.7. The clinic HR and the home HR were significantly different (p < 0.05). The upper limit of normality for HBP obtained from the values that correspond on the mean +2 SD to the CBP value of 140/90 was 135/82. The 95th percentile value of the HBP in the whole sample was 131/80. The upper limit of normality for HBP obtained from the values that correspond on the regression lines in the group with CBP < 140/90 was 125/78, in the group with CBP ≥ 140/90 was 130/81 and in the total sample was 128/81. Conclusions. We consider that the upper limit of normality of home blood pressure is 130/81. Clinic heart rate is higher than home heart rate, which demonstrates a phenomenon of alerting reaction

¿Nódulo de la hermana María José? / Sister Mary Joseph´ nodule?

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